Oregon Dental Insurance > Regence Life & Health Insurance Company > Dollar-Based Dental Plan
Premium Rates
Monthly Premium
Per Member
Quarterly Premium
Per Member
Dental Only
Dental & Vision
Dental Only
Dental & Vision
Under Age 18
$24.66
$27.27
$73.98
$81.81
18 through 64
$44.99
$49.61
$134.97
$148.83
65 and over
$56.98
$62.89
$170.94
$188.67
You may enroll for Dental Only Coverage or Dental with Vision Coverage.
All members must be enrolled for the same coverage and preimum payment schedule
Individual Dollar-Based Dental Benefits
$1,500 Annual Max
$1,250 Annual Max
$1,000 Annual Max
$750 Annual Max
Year 1
Year 2
Year 3
Year 4
Plan pays:
100% of the first $150 of care
80% of the next $500 of care
50% of the remaining care until annual benefit maximum is reached
Dollar Based Benefits
Percent covered
Benefit payment
Year 1
$0-$150*
100%
$150
$151-$650
80%
$400
$651-$1050
50%
$200
Maximum Policy Year Benefit
$750
Year 2
$0-$150
100%
$150
$151-$650
80%
$400
$650-$1550
50%
$450
Maximum Policy Year Benefit
$1,000
Year 3
$0-$150*
100%
$150
$151-$650
80%
$400
$651-$2050
50%
$700
Maximum Policy Year Benefit
$1,250
Year 4+
$0-$150*
100%
$150
$151-$650
80%
$400
$651-$2550
50%
$950
Maximum Policy Year Benefit
$1,500
Incentive: You control your benefit increase by receiving at least one cleaning and exam during the benefit year.
No deductibles
No limitations or exclusions for covered services, except orthodontia, theeth bleaching and veneers
Six month waiting period
Optional Vision Rider available: $150 in services and/or hardware every 24 months